Sexuality and Sexual Dysfunction in Later Life

  • Daniel L. Ambrosini
  • Rosemary Chackery
  • Ana Hategan


There has been a positive correlation between sexual activity and physical health, mental health, and overall quality of life. Sexual needs in later life appear to be similar to those in adult life with variations in frequency, intensity, and mode of expression. There are a number of societal, ideological, institutional, and physiological factors that can create barriers for adults in later life to achieve sexual expression. It is therefore important to acknowledge the changing nature of sexuality as one ages and not to pathologize it. A sexual dysfunction relates to any issue that arises during one of the stages of the sexual response cycle, which can be a common issue for both males and females especially during the aging process. Inappropriate sexual behaviors in institutionalized settings are more likely to occur in patients with major neurocognitive disorders. Because there is a need to balance autonomy rights of older patients while avoiding paternalism in institutionalized settings, ensuring the safety of patients and other sexual partners is paramount. Clinicians and other healthcare personnel working with older adults need to remain well-informed of legal and ethical issues related to the right to consensual sexual activity, which are discussed in this chapter.


Sexuality Sexual dysfunction Geriatric Sexual rights Late-life sexual expression Sexual disinhibition 


  1. 1.
    Kibble JD, Halsey CR. Medical physiology: the big picture. New York: McGraw-Hill; 2015.Google Scholar
  2. 2.
    UN General Assembly. Convention on the rights of persons with disabilities: resolution/adopted by the General Assembly. s.l. UN General Assembly: 24 January 2007, A/RES/61/106, 2007.Google Scholar
  3. 3.
    Rheaume C, Mitty E. Sexuality and intimacy in older adults. Geriatr Nurs. 2008;5(29):342–9.CrossRefGoogle Scholar
  4. 4.
    DeLamater J. Sexual expression in later life: a review and synthesis. J Sex Res. 2012;2-3(49):125–41.CrossRefGoogle Scholar
  5. 5.
    Chow E, Hategan A, Bourgeois J. When its time for “the talk”: sexuality and your geriatric patient. Curr Psychiatr Ther. 2015;5(14):13–30.Google Scholar
  6. 6.
    Hajjar RR, Kamel HK. Sexuality in the nursing home, part 1: attitudes and barriers to sexual expression. J Am Med Dir Assoc. 2004;5:S43–7.CrossRefGoogle Scholar
  7. 7.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013. p. 423–59.CrossRefGoogle Scholar
  8. 8.
    Lindau S. Sexuality, sexual function, and the aging woman. In: Halter JB, et al., editors. Hazzard’s geriatric medicine and gerontology. New York: McGraw-Hill; 2009. p. 6e.Google Scholar
  9. 9.
    Tenover J. Sexuality, sexual function, androgen therapy, and the aging male. In: Halter JB, et al., editors. Hazzard’s geriatric medicine and gerontology. New York: McGraw-Hill; 2009. p. 6e.Google Scholar
  10. 10.
    Saretsky K. The right to be human, how one facility cares. Provider. 1987;12:20–3.Google Scholar
  11. 11.
    Burns A, Jacoby R, Levy R. Psychiatric phenomena in Alzheimer’s disease, IV: disorders of behaviour. Br J Psychiatry. 1990;154:86–94.CrossRefGoogle Scholar
  12. 12.
    Holmes D, Reingold J, Teresi J. Sexual expression and dementia. Views of caregivers: a pilot study. Int J Geriatr Psychiatry. 1997;12:695–701.CrossRefPubMedGoogle Scholar
  13. 13.
    Haddad P, Benbow S. Sexual problems associated with dementia, part 2: etiology, assessment and treatment. Int J Geriatr Psychiatry. 1993;8:631–7.CrossRefGoogle Scholar
  14. 14.
    Taylor A, Margot GA. Sexuality in older age: essential considerations for healthcare professionals. Age Ageing. 2011;0:1–6.Google Scholar
  15. 15.
    American Associations of Retired Persons Survey. Sex, Romance, and Relationships: AARP Survey of Midlife and Older Adults. April 2010. Accessed 31 Oct 2016.
  16. 16.
    Waite LJ, Flicker L, Hankey GJ, Almeida OP, McCaul KA, Chubb SA, et al. Sexuality: measures of partnerships, practices, attitudes, and problems in the National Social Life, Health, and Aging Study. J Gerontol B Psychol Sci Soc Sci. 2009;64b:i56–66.CrossRefPubMedCentralGoogle Scholar
  17. 17.
    Herbenick D, Reece M, Schick V, Sanders SA, Dodge B, Fortenberry JD. Sexual behavior in the United States: Results from a national probability sample of men and women ages 14–94. J Sex Med. 2010;7(suppl 5):255–65.Google Scholar
  18. 18.
    Hyde Z, et al. Prevalence of sexual activity and associated factors in men aged 75 to 95 years: a cohort study. Ann Intern Med. 2010;7:693–702.CrossRefGoogle Scholar
  19. 19.
    Helgason AR, Adolfsson J, Dickman P. Sexual desire, erection, orgasm, and ejaculatory functions and their importance to elderly Swedish men: a population based study. Age Ageing. 1996;25:285–91.CrossRefPubMedGoogle Scholar
  20. 20.
    Paunonen M, Hagmann-Laitila A. Sexuality and the satisfaction of sexual needs: a study on the attitudes of aged nursing home clients. Scand J Caring Sci. 1990;4:163–8.CrossRefPubMedGoogle Scholar
  21. 21.
    McCracken AL. Sexual practice by elderly: the forgotten aspect of functional health. J Gerontol Nurs. 1988;14:13–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Gregorian RR, et al. Antidepressant-induced sexual dysfunction. Ann Pharmacother. 2002;36:1577–89.CrossRefPubMedGoogle Scholar
  23. 23.
    Tang S. When “Yes” Might Mean “No”: standardizing State criteria to evaluate the capacity to consent to sexual activity for elderly with neurocognitive disorders. Elder Law J. 2015;22:449–90.Google Scholar
  24. 24.
    Herring J, Wall J. Capacity to consent to sex. Med Law Rev. 2014;22:620–30.CrossRefPubMedGoogle Scholar
  25. 25.
    Curtice M, Mayo J, Crocombe J. Consent and sex in vulnerable adults: a review of case law. Brit J Learn Disabil. 2012;41:280–7.CrossRefGoogle Scholar
  26. 26.
    Murphy G, O’Callaghan A. Capacity of adults with intellectual disabilities to consent to sexual relationships. Psychol Med. 2004;34:1347–57.CrossRefPubMedGoogle Scholar
  27. 27.
    Perlin M. “Everybody is Making Love/or Else Expecting Rain”: considering the sexual autonomy rights of persons institutionalized because of mental disability in forensic hospitals and in Asia. Wash Law Rev. 2008;83:481–512.Google Scholar
  28. 28.
    Baggaley M. Sexual dysfunction in schizophrenia: focus on recent evidence. Hum Psychopharmacol. 2008;23(3):201–9.CrossRefPubMedGoogle Scholar
  29. 29.
    Nunes LV, Moreira HC, Razzouk D, Nunes SO, Mari JJ. Strategies for the treatment of antipsychotic-induced sexual dysfunction and/or hyperprolactinemia among patients of the schizophrenia spectrum: a review. J Sex Marital Ther. 2012;38(3):281–301.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Daniel L. Ambrosini
    • 1
  • Rosemary Chackery
    • 2
  • Ana Hategan
    • 3
  1. 1.McMaster University/St. Joseph’s Healthcare HamiltonHamiltonCanada
  2. 2.Royal Victoria Regional Health CentreBarrieCanada
  3. 3.Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonCanada

Personalised recommendations